Predicting First-Semester Performance of First-Year Medical Students in a Changing Landscape

Background Pre-medical admission factors, such as undergraduate science grade point average (GPA) and the Medical College Admission Test (MCAT), have been extensively studied to predict success in medical school and improve admissions processes. However, the first semester of medical school is critical for student retention and success and is often overlooked by studies that focus on end-of-program success. We analyzed several pre-admission factors to predict student performance on the challenging courses of anatomical sciences and molecular medicine in the first fall semester at an osteopathic medical school. Materials and methods This is a retrospective cohort study of 795 doctors of osteopathic medicine (DO) graduates from the 2019-2023 class cohorts. We analyzed the association between pre-medical admission criteria, such as science GPA, MCAT, and undergraduate majors, and performance in anatomy and molecular medicine courses. Results Students who met or exceeded the defined scores for competitive admission criteria for undergraduate GPA (p=0.006 and p=0.002), science GPA (both p<0.001), and MCAT total score (p=0.009 and p<0.001) achieved significantly higher grades for both anatomy and molecular medicine courses. Students with biological science majors performed better than those with non-science majors (p=0.002) in the molecular medicine course. Undergraduate majors did not have an association with the performance in the anatomy course. Conclusions Our data suggest that GPA, science GPA, MCAT score, and a biology undergraduate degree are significant correlates of improved performance in the challenging first semester of medical school. These findings can help schools identify and support at-risk students during the early, decisive phase of medical education.